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Study Shows Veterans with PTSD and Substance Use Disorder Have Higher Risk of Death

A research study conducted in partnership by the VA Ann Arbor Healthcare System and the University of Michigan Health System has shown that veterans who suffer from both PTSD and substance use disorder have an increased risk of death. This is the very first study which examines associations and links between substance use disorder and death for vets who have PTSD, and the study included data on the youngest veterans who have come back from the Iraq and Afghanistan conflicts. According to VA Ann Arbor post-doctoral fellow, University of Michigan research fellow, and lead author of the study Kipling Bohnert, Ph.D., the study provides some important clues about the best methods of treating veterans for positive outcomes.

Bohnert the study underlines the importance of treating veterans for both PTSD and substance use disorder, explaining “Attention needs to be paid to veteran patients with PTSD, with an emphasis on identifying those who might also have a problem with drug or alcohol use. This study highlights the potential importance of effective treatment for both conditions in helping veterans after they’ve returned from conflict.” More research is necessary to determine why younger vets seem to exhibit stronger associations between the risk of death and substance use disorders. Director of the National Serious Mental Illness Treatment Research & Evaluation Center at the VA Federic C. Blow, Ph.D., who is also the senior author of the study paper which was published, stated “In theory, a treatment program that addresses both issues — substance use and PTSD — should reduce the risk of death from all causes, and this may be especially true for the nation’s youngest veterans.”

Recent Study Shows Connection Between Stress Hormone Cortisol and Obesity in Many With Mental Illness

A recent study by researchers at the Umeå University in Sweden has found a connection between the stress hormone cortisol and obesity in patients with mental illness including bipolar disorder and depression. Low cortisol levels have been linked with obesity, a condition that leads to high blood levels of fat and metabolic syndrome as well as excess weight. Researchers determined that patients who had recurrent episodes of depression or bipolar disorder tended to have lower levels of cortisol, although extremely high levels of this stress hormone can also cause problems. The study results were published and can be found in the Journal of Affective Disorders. Both recurrent depression and bipolar disorder are life long conditions, and while there are treatments which can help with these disorders there are no cures.

According to Umeå University Department of Clinical Sciences Division of Psychiatry researcher Martin Maripuu the study examined the connection between patients with low levels of the stress hormone cortisol who also have a mental illness such as depression or bipolar disorder. These patients also struggle with obesity in many cases. Maripuu explained “These results provide clues to better understand the high prevalence of cardiovascular diseases in people with recurrent depressions or bipolar disorder. The results may in the future contribute to better preventative treatments of cardiovascular diseases in these disorders. The results show that cortisol regulation is linked to worsened physical health in people with bipolar disorder or recurrent depressions. However, further studies are needed in order to better understand these associations.”

Binge Drinking and Poor Self Control Linked in Study on Young Adults

A new study conducted at Florida Atlantic University has found that there is a link between binge drinking and poor self control in young adults. The study was designed to evaluate whether certain specific behavioral traits which were related to self control and inhibition behavior may increase the risk of binge drinking for some young adults. According to Florida Atlantic University Charles E. Schmidt College of Science psychology student and lead study author Andres L. Paz “There are many aspects of inhibition behavior, which is essentially the ability to stop yourself from a particular behavior. Looking specifically at risk factors, I wanted to see if there was one particular aspect of inhibition that could better predict propensity in young adults to binge drink.”

The FAU study on binge drinking and self control was published in the Alcohol and Alcoholism journal. Author Paz explained that “Perhaps our biggest takeaway from this study is that we suspect that the inability to withhold a response from stimuli plays a key role in putting a person at greater risk of binge drinking behaviors. We still don’t know if binge drinking puts you at risk of becoming an alcoholic or whether it is simply a phase you outgrow when you graduate. And what about weekend warrior binge drinkers?” Paz also cautioned that “There are so many elements involved with any kind of addiction including alcoholism. That is why it’s so important to continue research in this area to help us develop more personalized approaches to treat addiction. One size doesn’t fit all.”

Unavailable Parents and Family Teasing Over Weight Linked to Binge Eating in Kids

A new medical study links family teasing over weight and having unavailable parents to binge eating in kids. Kids who have parents who are not available physically or emotionally, and those who endure family teasing about their weight, have a higher risk of developing a binge eating disorder. The University of Illinois study also determined that race, income, and the weight of the parents did not have any impact on the eating patterns of the child. Illinois Transdisciplinary Obesity Prevention Program scholar and human development and family studies doctoral researcher Jaclyn Saltzman explained “This study found that childhood binge eating is really associated with parents’ weight-related beliefs, but not their actual weight, and their emotional availability but not necessarily the income availability.”

Early recognition and treatment for childhood binge eating could prevent many problems in adulthood. Unavailable parents and/or family teasing over weight can leave psychological scars that can compound the eating disorder. According to Saltzman “Intervening early to address binge eating may not only help prevent an eating disorder from emerging but also prevent lifetime habits of unhealthy weight-related behaviors. Loss of control is something that researchers have used to describe binge eating in young children. The idea is that the size of the binge — the amount of food they eat — is less important than the feelings of being out of control or the stress about that eating behavior, especially in young kids, because they don’t have all that much control over the food that they have access to. Binge eating is feeling like you are not in control when you are eating. You are eating past the point of fullness and to the point of discomfort. You are experiencing a lot of emotional distress because of it.”

Saltzman continued by explaining “We want to emphasize to parents that weight isn’t the ‘be all end all,’ and that focusing on weight too much can be damaging. Instead, focusing on giving kids the tools they need to manage their emotions, particularly emotions around eating and weight, can help strengthen children’s coping skills so they are less likely to need binge eating.”

Improved Rural Mental Health Services for Children Available Through Tele-Psychiatry

Children who live in rural areas where psychiatric care is difficult or impossible to access can now take advantage of better rural mental health services through tele-psychiatry. This therapy is video based and it can play a vital role for children who fall into a treatment gap. University of Missouri-Columbia researchers determined that most individuals who choose to utilize tele-psychiatry typically come from under served, rural, or remote areas where traditional services are not available on a wide scale. The American Academy of Child and Adolescent Psychiatry reports that only 20% of kids who have behavioral issues ever receive any type of mental health treatment. That is only 1 in 5. The other 80% fall through the cracks in the current mental health care system. Some obstacles to care can include financial hardship and a lack of suitable transportation.

According to University of Missouri School of Medicine assistant research professor of telemedicine and lead study author Mirna Becevic, Ph.D. the study underscores the need for tele-psychiatry services in order to reach children and adolescents who may need mental health treatment but who live in rural areas. Becevic explained “One of the biggest health care issues we as a nation face is a physician shortage in pediatric and adolescent behavioral health. Not surprisingly, the majority of Missouri physicians are located in urban areas along Interstate 70. Although there are child and adolescent psychiatrists in other areas of the state, many rural counties have none.”

Becevic went on to state “Our findings indicate that there is limited access to child and adolescent psychiatric services in our state. More important, our study illustrates how remote populations have severe barriers to access. The mental health shortage, especially in rural areas, is not a new discovery. However, this study highlights the severity of the need for mental health services in our state, especially for children and adolescents.”

Exposure to Nature Reduces Anxiety and Depression, Improves Overall Mental Health

A new study shows that nature is good for mental health, and that visiting parks and other nature areas could reduce anxiety and depression. A research study performed by University of Queensland and ARC Centre of Excellence for Environmental Decisions researchers found that people who spent at least 30 minutes a week in nature are also far less likely to suffer from poor mental health when compared to people who do not get back to nature for at least this small amount of time each week. This has led researchers to suggest that a minimum level of exposure to nature may be needed to improve mental health. The recent study was published and can be found in the journal Nature Scientific Reports.

Dr. Danielle Shanahan discussed the findings from the study on nature, mental health, and anxiety and depression. According to Dr. Shanahan there are many health benefits to visiting parks, and these include a lower risk of stress, heart disease, depression, and anxiety. “If everyone visited their local parks for half an hour each week there would be seven percent fewer cases of depression and nine percent fewer cases of high blood pressure. Given that the societal costs of depression alone in Australia are estimated at $A12.6 billion a year, savings to public health budgets across all health outcomes could be immense. Kids who grow up experiencing natural environments may benefit developmentally and have a heightened environmental awareness as adults than those who don’t.” This is just one more reason to get outside and enjoy the beauty of nature.

Self Stigma a Big Obstacle to Treatment for Mental Illness, Even With Online Options

Researchers at Iowa State University have found that self stigma is an obstacle to help for mental illness , even when the help was offered online in an anonymous setting. The study shows that people who have a greater sense of self stigma are significantly less likely to reach out to obtain information about treatment for mental disorders and mental illness. According to lead study author Daniel Lannin “Self stigma is a powerful obstacle to overcome.” The study looked at how participants responded when they had a chance to learn more about counseling services at the university and get further information about mental health help and treatment. According to Lannin “It’s not just the fear of seeing a counselor or therapist. It’s actually when people are sitting at home or on their phone. That stigma prevents them from even learning more information about depression or about counseling.”

370 participants took part in the study on self stigma and mental illness, and less than 10% of the participants either clicked a link to get more information or wanted to learn more about counseling. All of the study participants were college students. The study results were recently published and can be found in the Journal of Counseling Psychology. Lannin explained that “A lot of people with higher levels of stigma won’t even entertain the possibility of a stigma intervention because they see the intervention as going to therapy to be more open to therapy. It’s like telling someone who doesn’t like vegetables to eat some broccoli to get over it.” One possible solution is self affirmation interventions.

Could Enhanced Primary Care Improve the Outcome for Certain Mental Disorders?

A recent study on veterans has applications that could easily transfer to civilians with mental disorders like depression and PTSD as well. The study showed that enhanced primary care which included telephone therapy options, care managers with specialized training, and other primary care interventions could improve the outcome for veterans who were suffering from PTSD or depression. Researchers involved with the study were associated with RAND Corporation, the Department of Defense Deployment Health Clinical Center, and RTI International. The researchers determined that those who went to a primary care clinic with PTSD and depression experienced fewer symptoms over the next year and had better mental health. The study results were recently published in the JAMA Internal Medicine journal in the online edition.

Dr. Charles Engel was the lead author of the study on mental disorders and enhanced primary care. According to Dr. Engel “Although the improvements were modest, the reach of the program can be large and has the potential to bring more people under a high-quality treatment umbrella sooner. These findings suggest that the military health system might use this strategy to extend the reach of mental health care and reduce time to first treatment for PTSD and depression.” Dr. Engel went on to explain “Our findings are consistent with what has been observed in nonmilitary health care settings. This approach results in better outcomes and improves access to high-quality care. This is particularly important for a population that has a demonstrated need for mental health services. The results support the idea that high-quality mental health care can be provided in primary care settings. While many military members are reluctant to seek out mental health specialists, they are more willing to receive primary medical care. So this is a good way to encourage more people to receive mental health care, while also improving the quality of mental health services for military members.”

Study Links Air Pollution to Psychiatric Medications and Decreased Mental Health in Children

A recent Umeå University research study has concluded that there is a link between concentrations of air pollution and both decreased mental health and psychiatric medications in children under the age of 18. The researchers looked at air pollution exposure and psychiatric health in children and adolescents by studying register based medication data in a database which contains this information for all Swedes. The study also included air pollution concentration data from the Swedish National Register. The study looked at entire populations for a variety of Swedish countries with varying demographics, migration and socioeconomic characteristics, and other factors. The researchers determined that higher levels of air pollution also raised the risk that medication would be dispensed to address at least one psychiatric diagnosis for individuals under the age of 18.

The study on air pollution and mental health in children and adolescents should be a cause for concern. Researchers found that an increase of nitrogen dioxide concentration in the air by just 10 micrograms per cubic meter caused the risk of medication being dispensed to this age group for one or more psychiatric disorders by as much as 9%. This increase was calculated after the researchers took all possible factors including demographic and socioeconomic factors into account. Unit for Occupational and Environmental Medicine at the Department of Public Health and Clinical Medicine at Umeå University researcher Anna Oudin, Ph.D., the lead researcher for the study, explained that “The results can mean that a decreased concentration of air pollution, first and foremost traffic-related air pollution, may reduce psychiatric disorders in children and adolescents.”

Study Shows Possible Link Between Subtype of Autism and Inflammation During Second Trimester of Pregnancy

University of California Davis MIND Institute researchers have determined that there is a link between a subtype of autism which is combined with intellectual disability and a high level of inflammation during the second trimester of pregnancy. In the recent study the expectant mothers were determined to have two different inflammatory proteins responsible for controlling the communication between immune system cells in higher levels. The presence of higher levels of these inflammatory proteins, cytokines and chemokines, indicates an increased risk for this autism subtype.

According to UC Davis Center for Children’s Environmental Health director, Internal Medicine in the Division of Rheumatology, Allergy and Clinical Immunology professor, UC Davis MIND Institute researcher, and senior study author Dr. Judy Van de Water “Inflammation during the second trimester in the mothers of children with autism who also have intellectual disability was significantly greater than in mothers of children autism without intellectual disability in our study. However, equally significant was that profiles of mothers whose children go on to be diagnosed with autism and intellectual disability differed markedly from those whose children have intellectual disability without autism, as well as from the typically developing general population. Their profiles are distinct from all of the other groups that we studied, based on their cytokine and chemokine profiles. This finding suggests an avenue that we will explore to potentially identify possible markers to separate sub-phenotypes in the autism population.”

The goal of the study on biomarkers, autism, and inflammation was to evaluate various biomarkers. MIND Institute director Dr. Leonard Abbeduto explained “This study is incredibly valuable because it helps us understand more about the sources of variability within autism spectrum disorder, providing important insights into the different neurobiological mechanisms underlying important subtypes of the disorder. At the same time, the study reinforces the importance of the maternal immune system in to a host of child outcomes. Most importantly, this study brings us closer to knowing how to prevent adverse developmental outcomes.”

Abnormal Circadian Rhythm Could Impact Neurotransmitters For Those With Bipolar Disorder

A recent study has discovered a link between abnormal circadian rhythms and neurotransmitter changes for those who have bipolar disorder. The study covered a three year period. McLean Hospital researchers determined that those with bipolar disorder exhibited changes in the neurons in the brain that help regulate stress and anxiety, and these changes appeared to result from abnormal circadian rhythms. According to Harvard Medical School psychiatry instructor and McLean’s Translational Neuroscience Laboratory assistant neuroscientist Harry Pantazopoulos, Ph.D, one of the study researchers and the lead author, “For more than 50 years, there’s been evidence that there’s something wrong with circadian rhythms in people with bipolar disorder, but there has been a huge gap in terms of what we understand about their brains and how altered circadian rhythms are contributing to their symptoms.”

It has long been suspected that abnormal circadian rhythms and bipolar disorder have some association or connection, this latest study just confirms this. Pantazopoulos explained “Growing evidence points to a key role for somatostatin, a neurotransmitter in schizophrenia and bipolar disorder. In the amygdala, a part of the brain involved in anxiety and stress, somatostatin plays an important role in the regulation of anxiety and depression, often co-occurring in these disorders. We eventually saw that people with bipolar disorder have a very strong decrease of this protein in the beginning of the day while people without a psychiatric disorder normally have an increase in this protein. The decrease of the protein correlates very strongly with the established severity of depression and anxiety symptoms in people with mood disorders, in the morning. Therefore, our findings point to potential neural correlates of circadian rhythm abnormalities associated with specific symptoms in bipolar disorder.”

Diabetes Risk With Antipsychotic Medications May be Offset by Vitamin D

Antipsychotic medications often carry a high risk for the development of new onset diabetes, but a recent study has shown that taking vitamin D could lower this risk for those who take these drugs. Zyprexa, Seroquel, and other atypical antipsychotics are generally prescribed for disorders which are severe, including bipolar disorder, major depressive disorder, schizophrenia, and even autism. Kyoto University researchers have determined that vitamin D could help people with these disorders who must take these drugs minimize their risk of new onset diabetes. According to Takuya Nagashima, the lead author of the study, “Interestingly, vitamin D on its own doesn’t lower diabetes risk, but it certainly defends against the insulin-lowering effects of quetiapine. We clarified the molecular mechanisms of how quetiapine causes hyperglycaemia using datasets in a genomics data repository. Through this we found that quetiapine reduces the amount of a key enzyme called PI3K that gets produced. Vitamin D stops quetiapine from lowering PI3K production.”

Shuji Kaneko was the lead researcher on the study about antipsychotic medications, diabetes, and vitamin E. According to Kaneko “We found that patients who had coincidentally been prescribed vitamin D with quetiapine were less likely to have hyperglycaemia. It’s unusual for vitamin D to be prescribed with quetiapine because it is typically prescribed to treat osteoporosis; in fact, there were only 1232 cases in the world where vitamin D was prescribed with quetiapine. Data mining proved helpful in locating these cases. Databases like FAERS aren’t just for making drug regulations; they have so much potential for side-effect relief using pre-existing drugs. There’s a lot we can hope for from reverse translational research like this.”